As hospital hiring cools and financial pressures persist, health system leaders are intensifying their focus on retention, engagement and leadership trust.
While healthcare continues to drive U.S. job growth, hospital hiring has slowed, with at least 11 workforce reductions announced so far in 2026. At the same time, 2 in 5 healthcare workers say their roles feel unsustainable, and 1 in 4 are considering leaving the industry, according to an Indeed survey.
Against that backdrop, cutting turnover — and strengthening engagement — has remained a central focus for health system leaders.
Becker’s connected with five health system leaders about the workforce metrics that saw the greatest improvement over the past year — and what drove those gains.
Voluntary retention rate: Scripps Health
San Diego-based Scripps Health’s voluntary retention rate increased from 89% to 92% over the past 12 months, marking its most improved workforce metric, according to Eric Cole, corporate senior vice president of human resources.
“This improvement was driven by targeted actions that strengthened the employee experience, as reflected in our most recent employee listening survey,” Mr. Cole said. “Engagement remained strong at the 86th percentile, and a continued sense of belonging at the 85th percentile provided a stable foundation for retention.”
Scripps also saw significant gains across several key drivers of intent to stay, all of which performed in the top quartile. Fair pay increased by 18 basis points to the 84th percentile; adequate staffing rose by 17 basis points to the 88th percentile; tools and resources increased by 16 basis points to the 82nd percentile; and prioritization of patient safety increased by 15 basis points to the 78th percentile.
“Collectively, these improvements reflect deliberate decisions to invest in compensation fairness, strengthen staffing models, enhance operational support, and reinforce a culture of safety,” Mr. Cole said. “Each of these actions played a meaningful role in elevating the employee experience — and ultimately drove the measurable increase in voluntary retention.”
Leadership communication about the future: Onvida Health
Yuma, Ariz.-based Onvida Health saw measurable improvement in the survey question, “Senior leadership communicates a clear vision for the future,” in its annual engagement survey. The item scored 48% favorable in 2021 and, through refreshed purpose, pillars and values and CEO town halls, steadily increased to 70% in May, according to CHRO Matthew McElrath, EdD.
The system continued its listening efforts and identified additional opportunities to strengthen the score through reimagined rounding and frontline leadership meetings, reaching 82% favorable in November, Dr. McElrath said.
“We focused on this item because it has shown to drive engagement and helped us reach the 74th percentile,” he said. “With all the volatility in the market, staff want assurance that leadership has a plan for our future.”
Nursing workforce turnover: UPMC
Pittsburgh-based UPMC reduced nursing workforce turnover to 10% over the past year, compared to national benchmarks of 14% to 15%, according to Chief Nurse Executive Maribeth McLaughlin, BSN, RN.
“We’ve committed even further to flexibility in staffing so our nurses have greater opportunities for work-life harmony, enabling nurses to advance in their careers at a pace that suits their specific goals,” Ms. McLaughlin said.
Staffing options such as full-time, part-time, job share, weekend, steady off shifts, casual and flexible full-time roles have contributed to a more stable workforce, she said.
Engagement: Sinai Hospital of Baltimore
Sinai Hospital of Baltimore, part of LifeBridge Health, implemented in-person listening sessions, town halls and executive leader huddle board rounds to hear and act on real-time front-line feedback, President Amy Shlossman said.
The second prong focused on expanding recognition, including awards for team members who go above and beyond and “good catch” awards for staff who report potential safety risks. The hospital also built clinical career ladders for rehabilitation and respiratory therapists and nursing technicians to complement the nursing ladder, Ms. Shlossman said.
“These initiatives strengthened retention and hiring pipelines, with Sinai improving across every measure in our 2024-25 engagement survey and sustaining team sentiment nine points above the U.S. healthcare norm,” she said.
Rolling turnover rate: UAB Hospital
UAB Hospital in Birmingham, Ala., has decreased its rolling turnover rate by 7.54% over the past 12 months, placing it below the national average, according to CEO Brenda Carlisle, BSN, RN.
Over the same period, UAB Hospital also recorded a five-percentage-point increase in its engagement score and 14-percentage-point increase in employee survey response rates, Ms. Carlisle said.
“This positive trend reflects the combined impact of initiatives aimed at strengthening the employee experience, including the launch of a new recognition and rewards platform, strategic workforce planning efforts, and targeted market adjustments in key areas,” she said.
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